Dr. Dustin Ballard: Giving thanks for T-U-R-K-E-Y

LET'S BE CLEAR on one thing: Despite the traditional pastoral portrayal, the early pilgrims had it really rough.

Even those who survived the scurvy-filled float over the pond faced pestilence and death in the New World. More than half of the original Plymouth Rock pilgrims died within the first year. So, when they sat down for that celebratory harvest feast in 1621, they really were giving thanks for being alive — for not having died in childbirth, perished from pneumonia or malnutrition, or having caught leptospirosis (the rat urine-spread bacteria that had wiped out many of the surrounding Native Americans.)

Nowadays, as we sit down for our yearly feast, many of us give thanks for more mundane things such as gainful employment, rising real estate values and the new gold iPhone.

Really, though, we should all appreciate how lucky we are to live in a time and place where many of us of can (but should not) take our health for granted. Public health and medical advances have been truly remarkable in the past 75 years — antibiotics, vaccines, road and traffic safety improvements, and specialized systems of care and treatments are just a handful of the innovations that make us safer and healthier.

In Marin, we have even more to be thankful for. For instance, a recent study from the Institute for Health Metrics and Evaluation at the University of Washington measured the longevity of Marin women as the greatest in the country — 85.0 years — with Marin men not far behind (ranking fifth at 81.4 years.)

Furthermore, a county-based health rankings system compiled by the Robert Wood Johnson Foundation (http://www.countyhealthrankings.org) puts us No. 1 in the state overall as well as in multiple sub-categories.

So, with this in mind, I hope that this Nov. 28, you will consider a moment of T-U-R-K-E-Y-basted appreciation.

 T for Trauma care: Remarkably, for a modest population of about a quarter of a million, Marin County has three certified stroke centers, two cardiac catheterization labs and two ERs equipped to manage significant traumatic injuries (Marin General is a Level III trauma center and Kaiser San Rafael is county-designated as an Emergency Department Accepting Trauma). We also have an active and award-winning medical reserve corps (the Marin Medical Reserve Corps), a high ratio of available mental health specialists per capita (about fourfold the state average) and clinics sprinkled everywhere, including West Marin. Not surprising, Marin ranks No. 1 in California in the subcategory of "clinical care."

 U for Unusually good cardiac survival rates: This is because of unusually good community involvement with, and access to, life-saving techniques and equipment — most importantly citizen CPR and automated external defibrillators available in many public places. For example, in less than 10 years, the Novato Fire Foundation has donated more than 100 AEDs to the local community. All this has led to amazing rates of survival after sudden cardiac arrest. In the first half of 2013, out of 39 confirmed cardiac arrest victims who received ambulance response, 26 percent survived to hospital discharge — a rate many-fold above historical levels and those seen in other locales.

 R for Robust public health surveillance: From infectious disease to obesity in children to falls in the elderly, our public health apparatus is one of the best and most proactive in the state. "Just like a doctor uses vital signs to monitor a patient, we track hundreds of 'community vital signs' to monitor the health of Marin County," says Matt Willis, Marin's public health officer. "Whether it's outbreaks of infectious diseases or rates of injuries cancer or obesity, this information helps us protect Marin residents and promote healthy and long lives."

 K for Knowledge: We have an educated public that knows how to keep themselves and others healthy. Marinites do a good job of following preventive screening recommendations, taking their prescribed medications and eating their fruits and organic veggies. No scurvy in this county, that's for sure! We can, of course, do better — especially when it comes to vaccines and alcohol. Marin's rate of excessive alcohol consumption is one of the highest in the state.

 E for Environment: The physical environment of Marin is about as conducive to health as you can get — clean air with fine particulate rates 20 percent or so less than the rest of the state, plenty of parks and green space, and safe, tasty drinking water. And, with great weather, beaches and trails, it is difficult not to live an active lifestyle. Really, there aren't many ways we could have it better — although a BART line sure would be nice.

 Y for Your very own Marin IJ medical columnists: I, for one, will give thanks for those guys!

Dr. Dustin W. Ballard is an emergency physician at Kaiser Permanente San Rafael and the author of "The Bullet's Yaw: Reflections on Violence, Healing and an Unforgettable Stranger." His Medically Clear column appears every third Monday; follow him on Twitter at http://twitter.com/dballard30.